无骨折脱位型脊髓损伤的临床研究进展

脊柱的骨性结构除了支撑作用以外,还具有对脊髓的保护作用。临床上可以发现很多不引起骨质或关节损伤而仅仅引起脊髓损伤的患者。对于此种类型的损伤,所有研究和文献都支持：X-ray未发现椎骨有骨折、脱位的脊髓损伤。本文探讨了国内外学者关于此种损伤的原因、机制及治疗方法的不同见解。     

Deletion analysis of SMN1 and NAIP genes in southern Chinese children with spinal muscular atrophy

Spinal muscular atrophy (SMA) is a disorder characterized by degeneration of lower motor neurons and occasionally bulbar motor neurons leading to progressive limb and trunk paralysis as well as muscular atrophy. Three types of SMA are recognized depending on the age of onset, the maximum muscular activity achieved, and survivorship: SMA1, SMA2, and SMA3. The survival of motor neuron (SMN) gene has been identified as an SMA determining gene, whereas the neuronal apoptosis inhibitory protein (NAIP) gene is considered to be a modifying factor of the severity of SMA. The main objective of this study was to analyze the deletion of SMN1 and NAIP genes in southern Chinese children with SMA. Here, polymerase chain reaction (PCR) combined with restriction fragment length polymorphism (RFLP) was performed to detect the deletion of both exon 7 and exon 8 of SMN1 and exon 5 of NAIP in 62 southern Chinese children with strongly suspected clinical symptoms of SMA. All the 32 SMA1 patients and 76% (13/17) of SMA2 patients showed homozygous deletions for exon 7 and exon 8, and all the 13 SMA3 patients showed single deletion of SMN1 exon 7 along with 24% (4/17) of SMA2 patients. Eleven out of 32 (34%) SMA1 patients showed NAIP deletion, and none of SMA2 and SMA3 patients was found to have NAIP deletion. The findings of homozygous deletions of exon 7 and/or exon 8 of SMN1 gene confirmed the diagnosis of SMA, and suggested that the deletion of SMN1 exon 7 is a major cause of SMA in southern Chinese children, and that the NAIP gene may be a modifying factor for disease severity of SMA1. The molecular diagnosis system based on PCR-RFLP analysis can conveniently be applied in the clinical testing, genetic counseling, prenatal diagnosis and preimplantation genetic diagnosis of SMA. Project supported by the National Natural Science Foundation of China (No. J0710043), and the Natural Science Foundation of Zhejiang Province (No. 2007C33049), China     

Back injuries and the fast bowler in cricket

Here, I review research that has investigated the aetiology of injuries experienced by adolescent and adult fast bowlers. Mechanical factors play an important role in the aetiology of degenerative processes and injuries to the lumbar spine. This is particularly so in fast bowling, where a player must absorb vertical and horizontal components of the ground reaction force that are approximately five and two times body weight at front-foot and rear-foot impact, respectively. Attenuated forces are transmitted to the spine through the lower limb, while additional foces at the lumbo-sacral junction are caused by trunk hyperextension, lateral flexion and twisting during the delivery stride. Fast bowlers are classified as side-on, front-on or mixed. The mixed action is categorized by the lower body configuration of the front-on action and the upper body configuration of the side-on technique. This upper body configuration is produced by counter-rotation away from the batsman in the transverse plane about the longitudinal axis of the body of a line through the two shoulders. Counter-rotations of 12–40° during a delivery stride have predicted an increased incidence of lumbar spondylolysis, disc abnormality and muscle injury in fast bowlers. During the delivery stride, the mixed bowling action also shows: more lateral flexion and hyperextension of the lumbar spine at front-foot impact, and a greater range of motion of the trunk over the delivery stride when compared with the side-on and front-on techniques. The pars interarticularis of each vertebra is vulnerable to injury if repetitive flexion, rotation and hyperextension are present in the activity. Fast bowlers should reduce shoulder counter-rotation during the delivery stride to reduce the incidence of back injuries. When a player is required to bowl for extended periods irrespective of technique, overuse is also related to an increased incidence of back injuries and must be avoided.     

脊髓打击系统中打击锤的设计和打击力的测量

近年来,脊髓损伤的发病率逐年上升,受病人群越来越年轻化,且难以治愈,需要进行大量的临床试验对脊髓损伤的药物进行研究和测试,因此制备大量的,标准化的脊髓损伤模型就显得尤为重要,这就要求在打击过程中对打击力度有较准确的标定,针对脊髓打击器,设计了一种内置传感器的打击锤,通过记录打击过程中传感器的输出信号来测定打击过程中打击力的大小和变化趋势。     

人的脊柱及其运动的自然属性

通过人与灵长类动物脊柱的形态、结构及运动功能的解剖学比较，找出影响人类脊柱运动的某些因素。从人类社会的可持续发展来理解全民健身运动，强调体育运动的自然属性。提出以体育仿生学的运动方式来维护脊柱的运动能力。     

脊髓损伤动物模型研究概况

目的:研究近十年文献,探讨脊髓损伤动物模型的应用情况。方法:以"动物模型"、"脊髓损伤"为关键词在中国知网数据库、万方数据库上搜索近10年文献,概括总结脊髓损伤动物模型的研究现状。结论:SCI模型不断改进,向微观化、接近临床方向发展,模型多种多样,要根据自己研究方向有目的的选择合适的模型。     

猫后根初级传入纤维终末在后索核内的超微结构及其突触联系

用顺行溃变方法对猫后索核内后根初级传入纤维终末的超微结构和突触联系进行了研究。在切断C_4-T_1和L_4-S_1脊神经后根3～4天后,电镜下发现后索核内有三种溃变终末,出现最多的是电子致密型溃变,此外,也观察到了少量的神经微丝型溃变和电子透明型溃变。溃变的初级传入终末多数较大,含有圆形突触小泡。溃变初级传入终末作为突触前成分主要与后索核内的树突形成轴-树突触,而轴-体突触和轴-轴突较少。此外,还观察到溃变轴突终末参与形成突触复合体。     

Deletion analysis of SMN1 and NAIP genes in southern Chinese children with spinal muscular atrophy

Spinal muscular atrophy (SMA) is a disorder characterized by degeneration of lower motor neurons and occasionally bulbar motor neurons leading to progressive limb and trunk paralysis as well as muscular atrophy. Three types of SMA are rec-ognized depending on the age of onset, the maximum muscular activity achieved, and survivorship: SMA1, SMA2, and SMA3. The survival of motor neuron (SMN) gene has been identified as an SMA determining gene, whereas the neuronal apoptosis inhibitory protein (NAIP) gene is considered to be a modifying factor of the severity of SMA. The main objective of this study was to analyze the deletion of SMN1 and NAIP genes in southern Chinese children with SMA. Here, polymerase chain reaction (PCR) combined with restriction fragment length polymorphism (RFLP) was performed to detect the deletion of both exon 7 and exon 8 of SMNI and exon 5 of NAIP in 62 southern Chinese children with strongly suspected clinical symptoms of SMA. All the 32 SMAI patients and 76% (13/17) of SMA2 patients showed homozygous deletions for exon 7 and exon 8, and all the 13 SMA3 patients showed single deletion of SMN1 exon 7 along with 24% (4/17) of SMA2 patients. Eleven out of 32 (34%) SMA1 patients showed NAIP deletion, and none of SMA2 and SMA3 patients was found to have NAIP deletion. The findings of homozygous deletions of exon 7 and/or exon 8 of SMN1 gene confirmed the diagnosis of SMA, and suggested that the deletion of SMN1 exon 7 is a major cause of SMA in southern Chinese children, and that the NA1P gene may be a modifying factor for disease severity of SMA 1. The molecular diagnosis system based on PCR-RFLP analysis can conveniently be applied in the clinical testing, genetic counseling, prenatal diagnosis and preimplantation genetic diagnosis of SMA.     

腰椎管减压术后疼痛的原因分析及治疗进展

腰椎管减压手术是手术治疗腰椎间盘突出症及腰椎管狭窄症常用术式,但如何解决手术减压后早期出现的脊神经根性疼痛,目前国内外治疗腰椎管减压术后出现的根性疼痛主要依靠糖皮质激素的应用,术后静脉内滴注甘露醇、地塞米松及腰椎管减压术中在减压节段神经根鞘膜内注射曲安奈德用于治疗术后出现的根性疼痛;现将两种治疗方法用于治疗术后出现的神经根性疼痛的疗效、安全性的对比作出综述。     

Exercise intensity during wheelchair rugby training

Abstract

The purpose of this study was to determine the ability of individuals with a cervical spinal cord injury to achieve and sustain a cardiorespiratory training intensity during wheelchair rugby. Nine wheelchair rugby players completed a continuous peak exercise test on a SciFit Pro I arm ergometer with stage increases each minute to determine peak heart rate and power output. Approximately one week after peak exercise testing, heart rate was recorded (every 5 s) during three regularly scheduled rugby training sessions. Data were analysed to determine the number of continuous minutes that participants spent above 70% of heart rate reserve under various rugby training activities. The percent of time spent at or above 70% heart rate reserve varied across participants and conditions. Continuous pushing was the least variable training condition among participants with the sample averaging greater than 73% of time above the target heart rate. Scrimmage training was highly variable across participants with a range of 0% to 98% of time above the criterion. Results of this study indicate that wheelchair rugby training enables some participants to reach a training intensity associated with improved cardiorespiratory fitness, and that the type (or kind) of training activity dictates the extent to which individuals sustain such a threshold.